Status: Finalised
First registered on:
31/01/2023
Last updated on:
28/03/2023
1. Study identification
EU PAS Register NumberEUPAS50789
Official titleDARWIN EU® - Drug utilisation of valproate-containing medicinal products in women of childbearing potential
Study title acronym
Study typeObservational study
Brief description of the studyValproic acid/valproate-containing medicines are first-line treatment for epilepsy, and used as second-line treatments for the treatment of bipolar disorder and migraine prevention. Valproic acid/valproate is a teratogen, with prenatal exposure carrying a substantial risk of neurodevelopmental impairment and congenital malformations in the child. Therefore, its use in women of childbearing age is restricted to prevent valproate exposure during conception and pregnancy.
The European Medicines Agency commissioned this DARWIN EU© study to estimate the incidence rate and prevalence of VPA use and alternative treatments, and to characterise patient-level valproate use in women between aged ≥12 to ≤55 12 and 55 years of age from 2010 to 2022.
Was this study requested by a regulator?Yes: EMA
Is the study required by a Risk Management Plan (RMP)?
Not applicable
Regulatory procedure number (RMP Category 1 and 2 studies only)
Other study registration identification numbers and URLs as applicable
2. Research centres and Investigator details
Coordinating study entity
Centre nameDARWIN EU CC
Centre locationRotterdam, Netherlands
Details of (Primary) lead investigator
Title Dr
Last name Jodicke
First name Annika
Is this study being carried out with the collaboration of a research network?
Yes
Other centres where this study is being conducted
Multiple centres
In total how many centres are involved in this Study?5
Oxford University, UK
Auria Clinical Informatics, Hospital District of Southwest Finland, Finland
Countries in which this study is being conducted
International study
Belgium
Finland
Germany
Netherlands
Spain
United Kingdom
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed26/07/202226/07/2022
Start date of data collection01/01/201201/01/2012
Start date of data analysis
Date of interim report, if expected
Date of final study report17/01/202317/01/2023
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companies
Charities
Government body
Research councils
EU funding schemeEU funding scheme100
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Jodicke
First name Annika
Address line 1University of Oxford
Address line 2Windmill Road
Address line 3Headington
CityOxford
Postcode
CountryUnited Kingdom
Phone number (incl. country code)441865223725
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Dr
Last name Jödicke
First name Annika
Address line 1University of Oxford
Address line 2Windmill Road
Address line 3Headington
CityOxford
Postcode
CountryUnited Kingdom
Phone number (incl. country code)441865223725
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Substance class (ATC Code)N03AG01 and N03AG02
Single-Constituent (Substance INN)Sodium valproate
Single-Constituent (Substance INN) Valproate semisodium
Single-Constituent (Substance INN)Magnesium valproate
Single-Constituent (Substance INN)Valproic acid
Single-Constituent (Substance INN)Valpromide
7. Medical conditions to be studied
Medical condition(s)No
8. Population under study
Age
Adolescents (12 - 17 years)
Adults (18 - 44 years)
Adults (45 - 64 years)
Sex
Female
9. Number of subjects
Estimated total number of subjects20000
Additional information
>20'000
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources registered with ENCePP
Data sources not registered with ENCePP
Auria Clinical Informatics at Turku University Hospital, Hospital District of Southwest Finland, Finland
IQVIA Belgium LPD, Belgium
IQVIA Germany DA, Germany
Sources of data
Routine primary care electronic patient registry
Inpatient and outpatient specialist care records
11. Scope of the study
What is the scope of the study?
Drug utilisation study
Primary scope : Drug utilisation study
12. Main objective(s)
What is the main objective of the study?
1. To characterise the prevalence and incidence of use of valproate, valproate containing medicines, and alternative antiepileptic therapies among women aged 12 to 55 years of age, stratified by calendar year and age.
2. To characterise the use of valproic acid or valproate containing medicines among women aged 12 to 55 years of age, stratified by indication, calendar year and age.
Are there primary outcomes?Yes
1) Prevalence and incidence of valproate-containing medication and alternative treatments.
2) Patient-level drug utilisation
Are there secondary outcomes?No
13. Study design
What is the design of the study?
Cohort study
Drug utilisation study
14. Follow-up of patients
Will patients be followed up?Yes
Please describe duration of follow up
Participants will be followed up from the day of therapy initiation, i.e. the date of the first prescription of valproic acid/valproate-containing medication (index date), until the earliest of loss to follow-up, end of data availability, death, or end of continuous exposure
15. Data analysis plan
Please provide a brief summary of the analysis method
The study will be carried out as a Federated Network Analysis Project. All analyses will be conducted separately for each database. The data partners locally execute the analytics and review and approve the by default aggregated results before returning them to the DARWIN EU Coordination Centre. For all analyses a minimum cell count of 5 will be used when reporting results, with any smaller counts obscured.
Population level cohort study: Annual prevalence of valproate use and alternative treatments will be estimated, as will annual incidence rates per 100,000 person years.
New user cohort study: Large-scale patient-level characterisation will be conducted. Index date will be the date of the first VPA prescription for each person.
16. ENCePP seal
Are you requesting the ENCePP seal for this study?
No
17. Full protocol
18. Study Results
Please list the 5 most relevant publications using data from your study
ReferenceLink to web-publication
None
19. Other relevant documents
Conflict(s) of interest of
investigator(s)Not submitted
Composition of Steering Group and
ObserversNot submitted
Other documentsNot
submitted
Signed Code of
Conduct Checklist
Not submitted
Signed Code of Conduct Declaration
Not submitted
Signed Checklist for Study
Protocols
Not submitted
